Selective termination of a twin pregnancy as a treatment of severe pre‐eclampsia

Audibert, François; Salomon, Laurent; Castaigne-Meary, V.; Alves, Karine de Melo Cezar; Frydman, René

doi:10.1046/j.1471-0528.2003.02075.x

Cited by 29 publications

(2 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Elective premature birth, however, carries significant risks of prematurity in the AGA twin. Selective fetal reduction has a limited role in DC twins, due to the risk of preterm birth, but has been reported to be used in cases of severe preterm pre-eclampsia [23].…”

Section: Clinical and Research Implicationsmentioning

confidence: 99%

Selective Fetal Growth Restriction in Dichorionic Twin Pregnancies: Diagnosis, Natural History, and Perinatal Outcome

Antonakopoulos

Pateisky

Liu

et al. 2020

JCM

View full text Add to dashboard Cite

This study aims to evaluate the natural history, disease progression, and outcomes in dichorionic twins with selective fetal growth restriction (sFGR) according to different diagnostic criteria and time of onset. Dichorionic twins seen from the first trimester were included. sFGR was classified according to the Delphi consensus, and was compared to the outcomes of those classified by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) diagnostic criteria. Early sFGR occurred before 32-weeks, and late sFGR after 32-weeks. Disease progression, neonatal outcomes such as gestation at delivery, birthweight, neonatal unit (NNU) admission, and morbidities were compared. One-hundred twenty-three of 1053 dichorionic twins had sFGR, where 8.4% were classified as early sFGR, and 3.3% were late sFGR. Disease progression was seen in 36%, with a longer progression time (5 vs. 1 week) and higher progression rate (40% vs. 26%) in early sFGR. Perinatal death was significantly higher in the sFGR than the non-sFGR group (24 vs. 16 per 1000 births, p = 0.018), and those with early sFGR had more NNU admissions than late sFGR (p = 0.005). The ISUOG diagnostic criteria yielded a higher number of sFGR than the Delphi criteria, but similar outcomes. sFGR have worse perinatal outcomes, with early onset being more prevalent. Use of the Delphi diagnostic criteria can reduce over-diagnosis of sFGR and avoid unnecessary intervention.

show abstract

Section: Clinical and Research Implicationsmentioning

confidence: 99%

Selective Fetal Growth Restriction in Dichorionic Twin Pregnancies: Diagnosis, Natural History, and Perinatal Outcome

Antonakopoulos

Pateisky

Liu

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…To the best of our knowledge, there have been only 7 cases published. [6][7][8][9][10] Detailed information of these cases is shown in Table 1.…”

Section: Discussionmentioning

confidence: 99%

Resolution of preeclampsia after selective termination in discordant twins: A case report and literature review

et al. 2022

View full text Add to dashboard Cite

Rationale: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Growth discordance is associated with an increased risk of preeclampsia in twin pregnancies. The management of preeclampsia combined with discordant twins is difficult and controversial because of severe maternal conditions and severe growth restriction in 1 twin.Patient concerns: A 34-year-old woman with dichorionic diamniotic twin pregnancy complicated by preeclampsia at 29 weeks of gestation, and 1 twin with severe growth restriction and fetal intracranial hemorrhage. Diagnosis:The patient developed severe preeclampsia with high blood pressure (>160/100 mm Hg) and proteinuria, hydrothorax and leg edema. Ultrasound examination confirmed growth restriction (weight estimation: 915 g, <1st percentile) and abnormal umbilical flow in 1 twin (twin B), with a normal co-twin (estimated weight: 1693 g) (twin A). Magnetic resonance imaging revealed intracranial hemorrhage in the germinal matrix of twin B.Interventions: Selective termination of twin B by intracardiac injection of potassium chloride was performed at 31 weeks and 2 days' gestation.Outcomes: Symptoms of preeclampsia resolved after selective termination, allowing the pregnancy to be prolonged for nearly 4 weeks. A healthy female infant was delivered at 35 weeks of gestation.Conclusion: Delivery of both fetus is not the only choice for the management for twin pregnancy with severe preeclampsia and discordant twins. Selective termination of the fetus with poor prognosis could be a reasonable treatment choice in carefully selected cases.Abbreviations: EFW = estimated fetal weight, ICH = intracranial hemorrhage, IVF-ET = in vitro fertilization and embryo transfer, MRI = magnetic resonance imaging.

show abstract

Pre‐eclampsia: a maternal manifestation of a fetal adaptive response?

Espinoza

2011

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

Selective termination of a twin pregnancy as a treatment of severe pre‐eclampsia

Abstract: Fig. 1. Degree of proteinuria before and after selective termination. CASE REPORT 69 D RCOG 2003 Br J Obstet Gynaecol 110, pp. 68 -69

Cited by 29 publications

References 11 publications

Selective Fetal Growth Restriction in Dichorionic Twin Pregnancies: Diagnosis, Natural History, and Perinatal Outcome

Selective Fetal Growth Restriction in Dichorionic Twin Pregnancies: Diagnosis, Natural History, and Perinatal Outcome

Resolution of preeclampsia after selective termination in discordant twins: A case report and literature review

Pre‐eclampsia: a maternal manifestation of a fetal adaptive response?

Contact Info

Product

Resources

About